Saturday, August 17, 2019
National Health Protection Scheme
The National Health Protection Scheme (NHPS), also known as Pradhan Mantri Jan Arogya Yojana (PM-JAY) or Ayushman Bharat, is a government-sponsored health insurance scheme in India. Launched on September 23, 2018, by Prime Minister Narendra Modi, this ambitious program aims to provide financial protection and healthcare benefits to over 100 million families (approximately 500 million individuals) across the country, making it one of the largest publicly-funded health insurance schemes in the world.
Key Objectives and Features of National Health Protection Scheme:
1. Universal Health Coverage: NHPS aims to provide health insurance coverage to economically vulnerable families, ensuring that they have access to quality healthcare services without financial constraints.
2. Target Beneficiaries: The scheme primarily targets families belonging to socio-economically disadvantaged sections of society, identified based on the Socio-Economic Caste Census (SECC) data. It covers both urban and rural households.
3. Cashless Treatment: Under NHPS, beneficiaries are entitled to cashless treatment at empaneled hospitals and healthcare facilities. The scheme covers a wide range of medical and surgical procedures, including pre-existing conditions.
4. Coverage Limit: Each eligible family can avail of coverage of up to ₹5 lakh (approximately $7,000) per annum for hospitalization expenses. This coverage includes expenses related to hospital stay, surgeries, consultations, medications, and diagnostic tests, among other things.
5. Portability: The health insurance coverage under NHPS is portable, allowing beneficiaries to avail services at any empaneled hospital across India, irrespective of their location or the state in which they are registered.
6. Empaneled Hospitals: Hospitals and healthcare providers willing to participate in the scheme need to meet certain criteria and agree to the predefined package rates for various medical procedures. The government empanels private and public hospitals to ensure a wide network of healthcare providers.
7. Digitally Managed: NHPS operates on a digital platform, ensuring smooth administration, real-time tracking, and monitoring of beneficiaries and transactions. It utilizes technology to minimize fraud and improve transparency.
8. Health and Wellness Centers: NHPS is integrated with the government's plan to establish Health and Wellness Centers (HWCs) across the country. These centers provide comprehensive primary healthcare services and promote preventive healthcare.
NHPS aims to address the financial burden of medical expenses faced by vulnerable families and improve healthcare access for millions of Indians. By providing cashless healthcare services at a significant scale, the scheme plays a crucial role in enhancing the overall health and well-being of the population.